Reversing the Trend of Doctors Fleeing Medicare

July 31, 2013

A recent Wall Street Journal report underscores the need to reform the broken Medicare physician payment system. The WSJ reports, “Fewer American doctors are treating patients enrolled in the Medicare health program for seniors, reflecting frustration with its payment rates and pushback against mounting rules, according to health experts.” It goes on to explain, “Some experts attribute the rise in defections to Medicare payment rates that haven’t kept pace with inflation and the threat of more cuts to come. Under a budgetary formula enacted by Congress in 1997, physicians could see Medicare reimbursements slashed by 25% in 2014 unless Congress intervenes to delay the cuts, which it has done several times.”

This is precisely why the House Energy and Commerce Committee will vote today to repeal the broken sustainable growth rate (SGR) and replace it with a fair and stable system of payments that promotes the highest quality of care for America’s seniors and provides certainty for physicians so they can focus on treating their patients. This legislation is the result of more than two years of careful, transparent, and bipartisan work by members of the committee and the House Ways and Means Committee with input from medical experts and leading organizations. Learn more about the committee’s efforts here.  

More Doctors Steer Clear of Medicare
July 29, 2013

Fewer American doctors are treating patients enrolled in the Medicare health program for seniors, reflecting frustration with its payment rates and pushback against mounting rules, according to health experts.

The number of doctors who opted out of Medicare last year, while a small proportion of the nation's health professionals, nearly tripled from three years earlier, according to the Centers for Medicare and Medicaid Services, the government agency that administers the program. Other doctors are limiting the number of Medicare patients they treat even if they don't formally opt out of the system.

Even fewer doctors say they are accepting new Medicaid patients, and the number who don't participate in private insurance contracts, while smaller, is growing—just as millions of Americans are poised to gain access to such coverage under the new health law next year. All told, health experts say the number of doctors going "off-grid" isn't enough to undermine the Affordable Care Act, but they say some Americans may have difficulty finding doctors who will take their new benefits or face long waits for appointments with those who do.

CMS said 9,539 physicians who had accepted Medicare opted out of the program in 2012, up from 3,700 in 2009. That compares with 685,000 doctors who were enrolled as participating physicians in Medicare last year, according to CMS, which has never released annual opt-out figures before.

Meanwhile, the proportion of family doctors who accepted new Medicare patients last year, 81%, was down from 83% in 2010, according to a survey by the American Academy of Family Physicians of 800 members. The same study found that 4% of family physicians are now in cash-only or concierge practices, where patients pay a monthly or yearly fee for special access to doctors, up from 3% in 2010.

Read the entire story online here.

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